Background: A structure of everyday life creates routines and a sense of
familiarity, which provides a recognizable basis for being and acting in the
world. A structure of everyday life reduces stress, and daily stress has
consistently been associated with higher levels of psychiatric symptoms. Little
is known about how patients with schizophrenia and severe social impairment
structure their lives. Thus, we aimed to explore the everyday lives of this group of
patients, looking for structuring elements.
Methods: In this qualitative study, we included patients diagnosed with
schizophrenia who were either homeless or had difficulties reporting for
treatment and, thus, needed treatment from an outreach team.
Results: 17 participants were included in the study. We found only few structuring
elements across all participants in the qualitative analyses. We identified five
themes in our sample that serve as structuring elements in the everyday life:
social interactions, volunteering to assist with basic tasks, self-initiated routines
such as going for a walk daily, exoskeleton (structure provided by others), and
having pets. None of the participants reported much activity during the day, and
for most of them, social interactions were minimal.
Discussion: All the participants had very little structure and routines in their
everyday life. The shelters provided the homeless participants with some
structuring elements, whereas the domiciled participants had no external
structuring elements. The findings have important implications for
psychosocial treatment of severe social impairment in schizophrenia. The lack
of structure in these patients’ everyday lives highlights the need for targeted
interventions that could facilitate such structures and guide social involvement
and personal recovery.